Arthrodesis and arthroplasty of the first metatarsophalangeal joint in the treatment of severe rheumatoid forefoot deformities
https://doi.org/10.51922/1818-426X.2022.3.44
Abstract
The aim is to conduct a comparative assessment of the effectiveness of arthrodesis and arthroplasty of the first metatarsophalangeal joint (MPJ) in combination with the resection of the heads of the IIV metatarsals in the treatment of rheumatoid forefoot. The results of surgical treatment of the forefoot deformities in 36 patients with rheumatoid arthritis (RA) have been studied, 47 feet were operated on. In group 1 (n = 25 feet), arthrodesis of the first metatarsophalangeal joint was used (arthrodesis group). In group 2 (n = 22 feet), arthroplasty of the first metatarsophalangeal joint was performed using the KellerBrandes method (arthroplasty group). In both groups resection of the heads of the IIV metatarsals was performed. The American Orthopedic Foot and Ankle Society Hallux Scale (AOFASI) was used for clinical evaluation. The Hallux Valgus Angle (HVA) and 1–2Intermetatarsal Angle (1–2IMA) were measured for radiographic evaluation. The condition of the feet was assessed before surgery and in 6 and 24 months after surgery. We obtained better clinical results according to the AOFASI scale at 6 and 24 months after the surgery in group 1 with arthrodesis of the first metatarsophalangeal joint, compared with group 2 with arthroplasty according to the KellerBrandes method. In contrast to arthroplasty to the KellerBrandes method, arthrodesis of the first MPJ, allows to achieve stable correction of the Hallux Valgus Angle and reduce the 1–2Intermetatarsal Angle.
About the Authors
S. Aliakseichyk
УЗ «6-я городская клиническая больница г. Минска»
Belarus
Belarus
E. Mikhnovich
УО «Белорусский государственный медицинский университет»
Belarus
Belarus
N. Zhihar
УЗ «6-я городская клиническая больница г. Минска»
Belarus
Belarus
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Review
For citations:
Aliakseichyk S., Mikhnovich E., Zhihar N. Arthrodesis and arthroplasty of the first metatarsophalangeal joint in the treatment of severe rheumatoid forefoot deformities. Medical Journal. 2022;(3):44-49. (In Russ.) https://doi.org/10.51922/1818-426X.2022.3.44
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